Born in the USA: Having a baby is costly and confusing, even for a health policy expert

By Simon F. Haeder,Assistant Professor of Political Science, West Virginia University and first published on theconversation.com.

It is hard to believe that it has been just over since five months since our second son, Lukas, was born on Feb. 3. His mother, Hollyanne, is doing well, which is something to be thankful for, given the excessive maternal mortality rates in the U.S. Lukas is also healthy and growing, albeit sleeping little at night. What is unbelievable is the fact that I am still receiving bills for his birth.

I cannot imagine how overwhelming the experience must be for someone with fewer resources and less of an understanding about health care in America.

Being pregnant and giving birth: Not what it used to be

From the first doctor’s appointment, we were introduced to what to expect: lots of paperwork and lots of bills. There are of course all the monthly, then biweekly, and then weekly doctor’s visits with the corresponding bills.

In West Virginia, due to the opioid epidemic, most doctors will also insist on a drug screen.

As it turned out, my wife’s doctor ordered copious amounts of blood work and ultrasounds – “outpatient diagnostic services,” totaling thousands of dollars. It is hard to question any of these when all you want is a healthy baby – and your doctor is the only one who knows which tests are necessary.

Like most parents, we also wanted to know whether our baby was going to be healthy. Here is the total amount of the bill for genetic testing sent to our insurance company: US$26,755.

A stay in the maternity ward is pricey, even if the child birth itself is quick, as is was with the birth of Lukas Haeder.Inked Pixels/Shutterstock.com

Giving birth to our first son, Nico, had been quite an arduous experience for my wife. She labored for more than 30 hours. Determined not to spend hours in the hospital, my wife practically gave birth this time in the front seat of our car. Ultimately, I was able to throw my wife onto a bed in the maternity ward, and Lukas popped right out.

I joked to my wife: “At least they cannot charge us for delivery.” At the very least, I should file a claim with our insurance company.

I am still not quite sure how wrong I was, because every time I ask for a detailed bill, new items appear while others miraculously disappear.

About $65 an hour, for lodging

Various bills for the birth and care of Lukas and Hollyanne Haeder.Simon Haeder, CC BY-SA

The delivery room, which we used for all of one minute, cost about $7,000. Room and board for my wife for 48 hours cost just over $3,100. Two Tylenols for my wife: $25. Laboratory work: $1,200.

That does not account for Lukas. Room and board for him was just over $1,500. Various laboratory work charges added another $1,400 or so. The hearing test cost $260.

I tried to keep track of all the medical personnel coming and going, but after a while it all became a blur. The doctor, who was not present at birth, charged $4,200 for delivery and care. Pediatricians stopped by a few times to check on Lukas for $150 per look.

We were not able to take advantage of a tax-favored flexible spending account for most of these expenses, because “being pregnant” does not count as a “life event.” While “giving birth” does count, the added contributions cannot be applied to previous costs associated with the birth.

Bringing the baby home

As demanding as giving birth is, in many ways, the real challenges of raising children start when one leaves the hospital.

Like many American women, my wife, a teacher, did not have access to paid maternity leave. Hence, we had to make do with one income for a few months. Of course, this could not have been a more inconvenient time to lose a paycheck, because literally every day we received medical bills. Many of the bills misspelled someone’s name or got another fact wrong, which led to countless phone calls with providers and our insurer.

Diapers and other baby items, naturally, are also not cheap.

Once my semester ended in early May, my wife went back to work as I watched Lukas. This brought new challenges with it.

Finding an appropriate place and time to pump breast milk at work, even with a decent pump and governmental protections, comes with a slew of challenges. Currently my wife is using every free minute she can find and locks her classroom. Finding the time and space when doing continuing education or field trips is, of course, a whole other story.

My employer allows me to work from home during the fall semester so I can take care of Lukas at the same time. Of course, while I do not have to teach a class on campus, expectations about research and service will not diminish.

For us, and many others, this also meant cutting back on virtually everything, including family vacations and replacing appliances. It also meant taking up every opportunity to add income for both of us by taking side jobs.

Any potential future pay raises are likely to be swallowed up by premium increases and co-payments as health care cost continue to grow unabated.

Given these struggles, it is perhaps not surprising that the frustrations of the middle classbreed resentment toward publicly supported programs. Support for work requirements and more punitive and stigmatizing approaches to social programs are perhaps the understandable result.

Our current approaches to encourage and support parenthood are willfully inadequate. Health care, parental leave, day care, parental support, education. As a country, I think that we should strive to do better to support our families.